Treating epithelial defect several days after cornea cross-linking with the Athens protocol скачать в хорошем качестве

Treating epithelial defect several days after cornea cross-linking with the Athens protocol

We will describe the management of a relatively common “difficulty” in epithelialization of the cornea following the combined procedure of “our”Athens protocol for progressive keratoconus. In this gentleman the procedure went uneventfully, but instead of re-epithelializing in 4-5 days as it is typically expected, persistent epi defect was noted up to day 12. We were unable to accomplish re-epithelialization despite continuing the bandage contact lens and discontinuing temporarily topical corticosteroids. Thus the decision was made since the persistent epi defect was associated with “hyped-up” white possibly necrotic epithelial borders to enlarge the defect manually at the slit lamp. The. renew the bandage contact lens continue without topical corticosteroids and add oral doxycycline. The result: although the epithelium was unable to heal for about two weeks within four days of this intervention we had successful complete re-epithelialization. In cases like this careful external disease management is very important as if not a persistent epithelial defect can result in significant scarring